Given its inevitability, we all aspire to a good death - free of pain and with our wishes respected. As the Irish Hospice Foundation reminds us, most people want to die in their own homes. However, they don't always get what they want.
More than 60 per cent of the 30,000 or so who die in Ireland each year do so in various types of hospitals. Many spend their last hours in noisy wards, with little privacy, perhaps receiving unnecessary treatment. Their families can be sidelined amid the hospital bustle. The bereaved can be isolated.
This is why, in the wake of last week's launch by President McAleese of the foundation's Hospice - friendly Hospitals Programme, many hospitals are welcoming development co-ordinators from the foundation. Their aim is to assist in changing a culture that in the desire to cure can ignore death's inevitability.
This programme, which has been piloted at Our Lady of Lourdes Hospital in Drogheda, will result in rigorous national standards for dealing with death, dying and bereavement in our hospitals. In partnership with the HSE, the Health Information and Quality Authority, Atlantic Philanthropies and other organisations, hospitals are being asked to examine issues such as patient autonomy, dignity and design, communications and integrated care.
Standards of best practice will help ensure that patients have a good death and that the bereaved are treated appropriately. There will be guidelines aimed at guaranteeing that a patient's death does not offend his or her dignity. A key question will be whether his or her personal preferences were honoured. The tone is set, therefore, for a demanding five-year programme that aims to encourage hospice ideals, underpinned by agreed standards, and to assist hospitals with information, training, and specialist advice.
It is a tough task to change attitudes on dying but the Irish Hospice Foundation can be encouraged by the tenacity of voluntary groups that have shifted public perceptions on ageing. The foundation will know it has started to succeed when more thought is given to the relaying of bad news and when, for instance, relatives are not handed back a deceased patient's belongings in black plastic bags.
Broader questions can be tackled then. Why do we not facilitate more people to die at home? Do all medical staff appreciate the role of palliative care? Why do people commonly die in wards rather than single rooms? And how well trained are medical practitioners in end-of-life issues?